HB 0203 2003
1	CHAMBER ACTION
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6	The Committee on Finance & Tax recommends the following:
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8	Committee Substitute
9	Remove the entire bill and insert:
10	A bill to be entitled
11	An act relating to the Lower Florida Keys Hospital
12	District, Monroe County; providing legislative intent;
13	codifying, amending, repealing, and reenacting all special
14	acts relating to the district; repealing chapters 67-1724,
15	69-1322, 72-617, 73-555, 73-558, 75-450, 77-600, 77-601,
16	77-602, 77-603, 78-565, 79-511, 82-414, 87-459, 89-551,
17	and 94-415, Laws of Florida; providing an effective date.
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19	WHEREAS, the transactions authorized by this act will
20	enhance the efficiency of the delivery of hospital services to
21	residents of the district and protect the availability of needed
22	hospital services to residents of the district, including
23	indigent residents, NOW, THEREFORE,
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25	Be It Enacted by the Legislature of the State of Florida:
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27	Section 1. Pursuant to section 189.429, Florida Statutes,
28	this act constitutes the codification of all special acts
29	relating to the Lower Florida Keys Hospital District. It is the
30	intent of the Legislature in enacting this law to provide a
31	single, comprehensive special act charter for the district
32	including all current legislative authority granted to the
33	district by its several legislative enactments and any
34	additional authority granted by this act. It is further the
35	intent of this act to preserve all District authority in
36	addition to any authority contained in the Florida Statutes, as
37	amended from time to time.
38	Section 2. Chapters 67-1724, 69-1322, 72-617, 73-555, 73-
39	558, 75-450, 77-600, 77-601, 77-602, 77-603, 78-565, 79-511, 82-
40	414, 87-459, 89-551, and 94-415, Laws of Florida, are amended,
41	codified, reenacted, and repealed as herein provided.
42	Section 3. The charter for the Lower Florida Keys Hospital
43	District is re-created and reenacted to read:
44	Section 1. A special tax district is created and
45	incorporated in Monroe County to be known as the "Lower Florida
46	Keys Hospital District,” hereafter referred to as the
47	"district." Said district shall include that portion of Monroe
48	County embracing Key West and the Florida Keys that is between
49	range 24 east and range 31 east.
50	Section 2. The governing body of the Lower Florida Keys
51	Hospital District, hereinafter referred to as the "board," shall
52	consist of nine commissioners, of whom no more than one
53	commissioner may be a member of the medical profession. On or
54	before September 12, 1977, the Governor shall appoint all nine
55	commissioners as follows: two for a term of four years each,
56	two for a term of three years each, two for a term of two years
57	each, and three for a term of one year each. Thereafter, all
58	commissioners shall be appointed by the Governor for terms of
59	four years each and vacancies shall be filled by appointment by
60	the Governor for the unexpired term. All commissioners shall
61	serve without compensation and shall be qualified electors
62	residing in the Lower Florida Keys Hospital District for more
63	than one year prior to the appointment; at least three
64	commissioners shall reside in said hospital district other than
65	at Key West, at least three commissioners shall reside in Key
66	West, and the remaining commissioners shall reside in any area
67	of the district. The commissioners shall be reimbursed for per
68	diem and traveling expenses in accordance with the provisions of
69	s. 112.061, Florida Statutes. Each commissioner shall give bond
70	to the Governor for the faithful performance of his or her
71	duties in the sum of $5,000 with a security company qualified to
72	do business in this state as surety, which bond shall be
73	approved and kept by the Clerk of the Circuit Court of Monroe
74	County. The board shall elect annually one of its members chair
75	and shall elect or appoint a vice chair, a secretary, a
76	treasurer, and such other officers and assistants as the board
77	may determine, who need not be members of the board. The office
78	of secretary and treasurer may be held by one person. Should the
79	treasurer be other than a member of the board, he or she shall
80	give a like bond of $5,000 for the faithful performance of his
81	or her duties. Premiums on all bonds required by this section
82	shall be paid as part of the expenses of the district. The
83	Governor of the State of Florida shall have the power to remove
84	any member of said board for cause.
85	Section 3.
86	(1) The board shall have all the powers of a body
87	corporate, including, but not limited to, the power to sue and
88	be sued under the name of the Lower Florida Keys Hospital
89	District; to enter into contracts; to adopt and use a common
90	seal and to alter same at pleasure; to create, establish, or
91	otherwise acquire corporations, under the control of the
92	district, which corporations shall have all the powers
93	enumerated in chapter 607, Florida Statutes, unless prohibited
94	by the Florida Constitution or this act; to enter into capital
95	or operating leases; to acquire, purchase, hold, lease,
96	mortgage, and convey such real and personal property as the
97	board may deem proper or expedient to carry out the purposes of
98	this act; to appoint and employ an administrator, and such other
99	agents and employees as the board may deem advisable to operate
100	and manage the district’s facilities; to fix the compensation of
101	all employees and to remove any appointees or employees; to
102	ensure the improvements, fixtures, and equipment against loss by
103	fire, windstorm, or other coverage in such amounts as may be
104	determined reasonable and proper; to borrow money and to issue
105	evidence of indebtedness of the district therefor to carry out
106	the provisions of this act in the manner as set forth in this
107	act.
108	(2) Without limitation by any other provision of this act
109	and notwithstanding any other provision of this act, the
110	district is authorized and empowered to: form a Florida not-for-
111	profit corporation of which the district is the sole member but
112	which may include on its board a minority of the members thereof
113	designated by a private person; lease the district’s facilities
114	to such not-for-profit corporation; provide in such leases
115	options to sell and/or purchase such facilities for fair market
116	value as determined in a manner acceptable to the district;
117	transfer the operations of the district’s facilities to such
118	not-for-profit corporation; sell, assign, or transfer contracts
119	or leases of the district to such not-for-profit corporation;
120	and enter into and perform agreements for the provision of
121	hospital and other health care services to indigent and other
122	residents of the district, with all of the foregoing being on
123	such terms and conditions as the district in its sole discretion
124	may determine is in the public interest, but subject to
125	subsection (3). Nevertheless, the district shall supervise such
126	not-for-profit corporation by election of a majority of such
127	not-for-profit corporation’s board and by review and approval of
128	such not-for-profit corporation’s budgets, rates, and charges;
129	its policies regarding medical staff appointment, reappointment,
130	and adverse action; and its policies regarding admission and
131	discharge of patients and purchases of goods and services. Each
132	member of the not-for-profit corporation’s board must file full
133	and public disclosure of his or her financial interest in the
134	same manner and to the same extent as is required of
135	constitutional officers by Section 8 of Article II of the State
136	Constitution. For the purposes of the foregoing, the word
137	“person” has the meaning ascribed thereto in section 1.01,
138	Florida Statutes, 1989. This section does not abrogate or limit
139	the district’s responsibilities under this act relating to the
140	provision of indigent care to residents of the district.
141	(3) Any transaction entered into pursuant to subsection
142	(2) must:
143	(a) Provide that the articles of incorporation of each
144	such not-for-profit corporation be subject to the approval of
145	the board of commissioners of the district;
146	(b) Provide for the orderly transition of the district’s
147	hospital facilities to not-for-profit corporate status; and
148	(c) Provide for the return of the district’s facilities
149	upon termination of the lease thereof or dissolution of such
150	not-for-profit corporation except that the district may not be
151	prohibited from granting and performing options to purchase any
152	or all of the district’s facilities for fair market value
153	determined in a manner acceptable to the district.
154	(d) Any transfer, sale, or lease of a hospital facility by
155	the district shall be preconditioned upon the transferee, buyer,
156	or lessee providing, on an annual basis, an amount of indigent
157	care and Medicaid care to residents of the district which is not
158	less than the amount of such care previously provided by the
159	hospital as reported to the Health Care Cost Containment Board
160	in the last year prior to the transfer, sale, or lease of the
161	hospital facility, provided there is the demand for such level
162	of indigent care and Medicaid care in the district. Any
163	contract, agreement, or lease of a hospital entered into by the
164	district shall also comply with the provisions of section
165	155.40, Florida Statutes.
166	Section 4. Regular meetings shall be held not less than
167	quarterly, but may be held as frequently as deemed necessary,
168	which additional regular meetings shall be called in the same
169	manner as special meetings. A special meeting may be called by
170	the chair or at the request of three (3) members of the board of
171	commissioners, and said meeting shall be held no later than
172	three (3) days from the date called or requested. A quorum for
173	special and regular meetings shall consist of at least one half
174	(1/2) of the membership of said board then appointed, qualified,
175	and so serving. Death and accepted resignation of members shall
176	not be considered in ascertaining the number necessary for a
177	quorum. In the absence of the chair or his or her inability to
178	act at any regular or special meeting, warrants for payment of
179	money may be signed by the vice chair or by any other member of
180	the board selected by the members present as chair pro tem.
181	Section 5. The board through its secretary, or secretary-
182	treasurer as the case may be, shall keep true and accurate
183	minutes and records of all business transacted by it, and shall
184	keep full, true, and complete books of account and minutes,
185	which minutes, records, and books of account at all reasonable
186	times shall be open and subject to inspection and copying by any
187	inhabitant of the district. Failure to comply with this section
188	shall constitute a misdemeanor and be punishable as such as
189	provided by law.
190	Section 6. The board is authorized to establish,
191	construct, lease, operate, and maintain a hospital or hospitals,
192	medical facilities, and other health care related facilities and
193	services as in its opinion shall be necessary for the use of the
194	people of the district. Said hospital or hospitals, medical
195	facilities, and other health care related facilities and
196	services shall be established, constructed, leased, operated,
197	and maintained by the board for the preservation of the public
198	health, for the public good, and for the use of the public of
199	the district, and maintenance of such hospital or hospitals,
200	medical facilities, or other health care related facilities and
201	services within the district is hereby found and declared to be
202	a public purpose and necessary for the preservation of the
203	public health and welfare of the district and inhabitants
204	thereof. The board may enter into contractual relationships
205	with other health service organizations, either public or
206	private, for the provision of such administrative and medical
207	services as it does not on its own provide in connection with
208	said hospital or hospitals, medical facilities, or other health
209	care related facilities and services. The location of any
210	hospital, medical facility, or other health care related
211	facility established under this act shall be determined by the
212	board. The board is authorized to accept any and all gifts,
213	loans, or advancements for the purchase of property, real or
214	personal, for the construction, equipping, and maintenance of
215	any hospital, medical facility, or other health care related
216	facility established hereunder.
217	Section 7. (1) Before any single purchase of merchandise,
218	supplies, materials, machinery, or equipment is made, the price
219	of which exceeds five thousand dollars ($5,000.00), or any
220	contracts for any construction work is let, the price of which
221	exceeds five thousand dollars ($5,000.00), there shall be an
222	advertisement by the board at least one (1) time in a newspaper
223	of general circulation published in Key West, inviting sealed
224	bids or proposals to furnish such merchandise, supplies,
225	materials, machinery, or equipment or to perform such
226	construction. Sealed bids or proposals received shall be
227	properly evaluated by the board and the lowest responsible bid
228	or proposal shall be accepted unless the board shall reject all
229	sealed bids or proposals. If all sealed bids be rejected, new
230	sealed bids or proposals shall be solicited by advertisement.
231	The board may, by resolution or motion, dispense with
232	advertising for sealed bids or proposals in the event of an
233	emergency requiring that merchandise, supplies, materials,
234	machinery, or equipment or construction work is necessary and
235	required. If after two (2) successive unsuccessful attempts to
236	obtain sealed bids or proposals, or in the event of an
237	emergency, the board may purchase merchandise, supplies, or
238	materials or contract for construction or repairs by negotiation
239	with suppliers or contractors. When an emergency is declared to
240	exist by action of the majority of the board members meeting in
241	a regular or special meeting, the basis of such determination
242	and the vote of each member of the board shall be set forth in
243	writing in the minutes of the meeting.
244	(2) The district’s board of commissioners is specifically
245	delegated the authority to grant, deny, revoke, or suspend staff
246	privileges at its hospitals, medical facilities, or other health
247	care related facilities according to the applicable Florida
248	Statutes and the applicable rules and regulations. A decision
249	of the board of commissioners of the Lower Florida Keys Hospital
250	District to refuse, revoke, or suspend membership on the staff,
251	or to refuse, revoke, or suspend any privileges attendant to
252	such membership, is hereby declared to be a quasi-judicial
253	function of the board and judicial review of such decision shall
254	be by petition for certiorari to the District Court of Appeal of
255	Florida prescribed by the Florida Appellate Rules having
256	jurisdiction of the appeals from Monroe County, in the time and
257	manner prescribed by the Florida Appellate Rules for such
258	petitions for writ of certiorari, unless the provisions of such
259	appellate rules shall confer exclusive jurisdiction of such
260	petition upon the Supreme Court of Florida.
261	Section 8. The board in its discretion is authorized to
262	establish and maintain in connection with any hospital, medical
263	facility, or other health care related facility established
264	under this act a training school for nurses and other health
265	care related professionals, which school must conform to all the
266	requirements of the general state law governing schools of
267	professional nursing and the practice of nursing and such other
268	professional sciences. The board is authorized to promulgate
269	and adopt all rules and regulations necessary or required by
270	general law for the operation of such training schools and to
271	make all necessary expenditures in connection therewith. The
272	board is also authorized in its discretion to establish,
273	operate, and maintain a nursing home, an ambulance service, and
274	such other services related to the operation and maintenance of
275	a hospital, medical facility, or other health care related
276	facility in a manner provided by general law.
277	Section 9. The board of commissioners is authorized and
278	empowered, at any time in its discretion, to establish,
279	maintain, or participate in such programs and projects of and
280	for medical research, education, and development affecting human
281	physical or mental health and well-being as it may deem
282	desirable; and in connection with such programs and projects the
283	board of commissioners is authorized and empowered to cooperate
284	with public and private educational or research institutions,
285	corporations, foundations, or organizations of any and all types
286	as well as agencies, departments, divisions, branches, or bodies
287	of government, or created by government, whether federal, state,
288	county, municipal, or otherwise. In furtherance of such
289	programs and projects, the board of commissioners is further
290	authorized and empowered to expend moneys and utilize assets and
291	property, real or personal, of the district and to receive
292	donations, grants, or gifts of money or property, real or
293	personal, from any person or persons, firm, organization,
294	corporation, society, institution, foundation, or legal entity
295	of whatever nature whether private, governmental, or public.
296	Section 10. To carry out the provisions of this act, the
297	board is authorized to borrow money from time to time for
298	periods of time not exceeding one (1) year at any one time and
299	to issue any note of the district therefor upon such terms and
300	upon such rates of interest not exceeding the current prime rate
301	as the board may deem advisable and to secure the payment of
302	same by note or mortgage and note upon any property, real or
303	personal, owned by the district. The board shall have the
304	additional right to pledge as security for money borrowed any
305	moneys accruing to it or to accrue to it from any source,
306	including revenues derived from the operation of any hospital
307	established under this act; provided, however, that the
308	aggregate amount of principal of moneys so borrowed upon the
309	note or notes of the district shall not at any one time exceed
310	the sum of $3 million or 20 percent of the appraised value of
311	the capital assets of the district, whichever sum is greater.
312	The board shall have the authority to receive and accept grants,
313	gifts, and donations from any person, firm, trust, foundation,
314	corporation (whether profit or nonprofit), partnership, estate,
315	or governmental agency. The board shall have exclusive control
316	of all expenditures of and from the moneys, loan proceeds,
317	contributions, and revenues of the district, except that persons
318	who desire to make contributions to the district shall have the
319	right to attach conditions to their gifts. The board, upon
320	accepting any such contribution, shall be controlled by the
321	terms of the gift, bequest, or devise, and may, in such cases,
322	establish funds therefor separate and apart from items of
323	general revenue. Any such contribution made to the district
324	without conditions attached thereto may be expended by the board
325	for such purposes as shall be deemed necessary and proper by the
326	board of commissioners.
327	Section 11. The board is authorized to issue bonds of the
328	district bearing interest for the purposes set forth in this
329	act, for the purpose of raising funds to establish, construct,
330	refinance, or pay off existing obligations previously incurred
331	on capital expenditures, and maintain any hospital as in the
332	board’s opinion is necessary in the district, and for the
333	acquisition and development of real property, including
334	appurtenances, fixtures, and equipment, and for major repairs or
335	renovations to real property which significantly extend its
336	useful life or change its function, and for any necessary
337	operating capital outlay to furnish and operate a new or
338	improved facility. The board shall have the power to refund any
339	and all previous issues of bonds for any and all lawful hospital
340	purposes. All the proceeds derived from the sale of bonds or
341	refunding bonds, exclusive of expenses, shall be deposited in a
342	depository selected by the board. Nothing herein shall limit
343	any rights the district has or may have under general law.
344	Section 12. Prior to the issuance of bonds, the board
345	shall, by resolution, determine the amount which in its opinion
346	will be necessary to be raised annually by taxation for an
347	interest and sinking fund with which to pay the interest and
348	principal of the bonds; and the board is authorized and required
349	to provide annually for the levy and collection of a sufficient
350	tax upon all the taxable property in the district, not exempt by
351	law, to pay such interest, and with which to provide and
352	maintain a sinking fund for the payment of the principal of
353	bonds.
354	Section 13. All bonds issued by the board, except
355	refunding bonds, revenue bonds, or certificates and anticipation
356	time warrants, shall be issued only after the same shall have
357	been approved by the majority vote of the electors voting in an
358	election called and held by the board subject to reasonable
359	rules and regulations prepared by the board. In the event it is
360	determined to hold an election to decide whether the electors
361	are in favor of the issuance of bonds, the board, by resolution,
362	shall order an election to be held in the district and shall
363	give 30 days' notice of election by publication in a newspaper
364	of general circulation within the district once a week for 4
365	consecutive weeks during such period.
366	Section 14. Only registered electors of the district shall
367	be permitted to vote at a bond election. For the purpose of
368	determining the total number of qualified electors residing in
369	the district, the Supervisor of Registration of Monroe County
370	shall prepare a list of the names of all qualified electors
371	appearing upon the registration books of Monroe County and
372	qualified to vote in the election. Such lists shall be
373	furnished to the inspectors or clerks of the election at each
374	voting place and such lists shall be prima facie evidence of the
375	total number of qualified electors eligible to participate in
376	the election. No person shall be permitted to vote in such
377	election whose name does not appear on such list.
378	Section 15. As far as practicable and where not
379	inconsistent with the provisions of this act, the procedure
380	outlined in chapter 100, Florida Statutes, providing the
381	procedure for bond elections, shall govern.
382	Section 16. All bonds issued under this act shall be in
383	the denomination of $500 or some multiple thereof, shall bear
384	interest payable annually or semiannually, and both principal
385	and interest shall be payable at such prices as the board may
386	determine. The form of such bond shall be fixed by resolution
387	of the board and said bonds shall be signed by the chair and
388	countersigned by the secretary under the seal of the district.
389	The coupons, if any, shall be executed by the facsimile
390	signatures of said officers. The delivery at any subsequent
391	date of any bond and coupons so executed shall be valid,
392	although before the date of delivery the persons signing bonds
393	or coupons shall cease to hold office.
394	Section 17. Bonds issued hereunder may be either
395	registered or coupon bonds. Coupon bonds may be registered as
396	to principal in the holder’s name on the books of the district,
397	the registration being noted upon the bonds, after which no
398	transfer shall be valid unless made on the district’s books by
399	the registered holder and similarly noted on the bonds. Bonds
400	registered as to principal may be discharged from registration
401	by being transferred to bearer, after which they shall be
402	transferable by delivery, but may be again registered as to
403	principal as before. The registration of the bonds as to
404	principal shall not restrain the negotiability of the coupons by
405	delivery merely.
406	Section 18. Before any bonds of the district are issued
407	hereunder, the board shall investigate and determine the
408	legality of the proceedings. The resolution authorizing the
409	bonds may direct that they shall contain the following recital:
410	"It is certified that this bond is authorized by and is issued
411	in conformity with the requirements of the constitution and
412	statutes of the State of Florida."
413	Such recital shall be an authorized declaration by the board and
414	shall import that there is constitutional and statutory
415	authority for incurring the debts and issuing the bonds; that
416	all the proceedings therefor are regular; that all acts,
417	conditions, and things required to exist, happen, and be
418	performed precedent to and in the issuance of the bond have
419	existed, happened, and been performed in due time, form, and
420	manner, as required by law; and that the amount of the bond,
421	together with all other indebtedness, does not exceed any limit
422	prescribed by the constitution and statutes of this state. If
423	any bond be issued containing the recital, it shall be
424	conclusively presumed that the recital, construed according to
425	the import hereby declared, is true, and the district shall not
426	be permitted to question the validity or legality of the
427	obligation in any court in any action or proceeding.
428	Section 19. In issuing bonds under the provision of this
429	act, it shall be lawful for the board to include more than one
430	(1) improvement or hospital purpose in any bond issue.
431	Section 20. All bonds issued hereunder shall be advertised
432	for sale on sealed bids, which advertisement shall be published
433	once a week for three (3) weeks, the first publication to be
434	made at least twenty-one (21) days preceding the date fixed for
435	the reception of bids, in a newspaper published in the hospital
436	district. Notice of sale shall also be published once a week
437	for three (3) weeks preceding the date fixed for the reception
438	of bids, either in a financial paper published in the city of
439	New York, the city of Chicago, or the city of Baltimore, or in a
440	newspaper of general circulation published in a city in Florida
441	having a population of not less than twenty thousand (20,000)
442	inhabitants according to the latest official decennial census.
443	The board may reject any and all bids. If the bonds are not
444	sold pursuant to such advertisements, they may be sold by the
445	board at private sale within sixty (60) days after the date
446	advertised for the reception of sealed bids, but no private sale
447	shall be made at a price less than the highest bid which shall
448	have been received. If not sold, bonds shall be readvertised in
449	the manner herein prescribed. No bonds issued hereunder shall
450	be sold for less than ninety-five percent (95%) of the par value
451	and accrued interest.
452	Section 21. No resolution or proceeding in respect to the
453	issuance of bonds shall be necessary except as required by this
454	act. Any publication prescribed hereby may be made in any
455	newspaper conforming to the terms of this act, without regard to
456	the designation thereof as the official organ of the district.
457	Bonds issued hereunder shall have all the qualities of
458	negotiable paper under the law merchant, shall not be invalid
459	for any irregularity or defect in the proceedings for the issue
460	and sale thereof, and shall be incontestable in the hands of a
461	bona fide purchaser or holder for value.
462	Section 22. The board shall have the power to provide by
463	resolution for the issuance of refunding bonds to refund
464	principal and interest of an existing bond indebtedness, for the
465	payment of which the tax moneys derived from the district is
466	pledged, and such bonds may be issued at or prior to maturity of
467	the bonds to be refunded. Such resolution may be adopted at a
468	regular or special meeting, and at the same meeting at which it
469	is introduced, by a majority of the members of the board then in
470	office. It is determined and declared as a matter of
471	legislative intent that no election to authorize the issuance of
472	refunding bonds shall be necessary except in cases where an
473	election may be required by the state constitution. In all
474	cases where it is not necessary under the constitution to hold
475	an election on the issuance of such refunding bonds, such
476	resolution shall take effect immediately upon the adoption
477	thereof. No other proceedings shall be required for the
478	issuance of bonds by the district other than the provisions of
479	section 20 of this act which shall be applicable to this
480	section.
481	Section 23. The resolution of the board authorizing the
482	issuance of the refunding bonds may provide that the refunding
483	bonds may be issued in one (1) or more series, bear the date,
484	mature at the time not exceeding thirty (30) years from their
485	respective dates, bear interest at the rate not exceeding the
486	maximum rate of interest borne by the notes, bonds, or other
487	obligations refinanced thereby, be in the denomination, be in
488	the form either coupon or registered, carry the registration and
489	conversion privileges, be executed in the manner, be payable in
490	the medium of payment at the place, be subject to the terms of
491	redemption with or without a premium, be declared or become due
492	before the maturity date thereof, provide for the replacement of
493	mutilated, destroyed, stolen, or lost bonds, be authenticated in
494	the manner and upon compliance with the conditions, and contain
495	such other terms and covenants as may be desired.
496	Notwithstanding the form or tenor of a bond and in the absence
497	of an express recital on the face that the bond is
498	nonnegotiable, all refunding bonds shall be considered
499	negotiable instruments for all purposes.
500	Section 24. Refunding bonds bearing the signature of board
501	officers of the district in office on the date of the signing
502	thereof shall be valid and binding obligations of the district
503	for all purposes, notwithstanding that before the delivery
504	thereof any or all of the persons whose signatures appear
505	thereon shall have ceased to be officers of the district. Any
506	resolution authorizing refunding bonds may provide that any
507	refunding bonds issued pursuant to this act may contain such a
508	recital, and any refunding bond issued under authority of any
509	resolution shall be conclusively deemed to be valid and to have
510	been issued in conformity with the provisions of this act. The
511	authority of a district to issue obligations under this act may
512	be determined and obligations to be issued under this act may be
513	validated as provided by law.
514	Section 25. Refunding bonds may be sold or exchanged as
515	follows:
516	(1) In installments at different times, or an entire issue
517	or series may be sold or exchanged at one (1) time. Any issue
518	or series of refunding bonds may be exchanged in part or sold in
519	parts in installments at different times or at one (1) time.
520	The refunding bonds may be sold or exchanged at any time on,
521	before, or after the maturity of any of the outstanding notes,
522	bonds, certificates, or other obligations to be refinanced
523	thereby.
524	(2) If the board determines to exchange any refunding
525	bonds, the refunding bonds may be exchanged privately for and in
526	payment and discharge of any of the outstanding notes, bonds, or
527	other obligations of the district. The refunding bonds may be
528	exchanged for a like or greater principal amount of notes,
529	bonds, or other obligations of the district, except the
530	principal amount of the outstanding notes, bonds, or other
531	obligations to the extent necessary or advisable, in the
532	discretion of the board, to fund interest in arrears or about to
533	become due. The holder of outstanding notes, bonds, or other
534	obligations need not pay accrued interest on the refunding bonds
535	to be delivered in exchange therefor if and to the extent that
536	interest is due or accrued and unpaid on the outstanding notes,
537	bonds, or other obligations to be surrendered.
538	(3) If the board determines to sell any refunding bonds,
539	the refunding bonds shall be sold at not less than ninety-five
540	percent (95%) of par at public or private sale, in such manner
541	and upon the terms the board shall deem best for the interest of
542	the district.
543	Section 26. All bonds or refunding bonds issued pursuant
544	to this act shall be legal investments for state, county,
545	municipal, and all other public funds and for banks, savings
546	banks, insurance companies, executors, administrators, trustees,
547	and all other fiduciaries, and shall also be and constitute
548	securities eligible as collateral security for all state,
549	county, municipal, or other public funds.
550	Section 27. The funds of the district shall be paid out
551	only upon warrants signed by the chair or vice chair or such
552	other member of the board designated by the board. Warrants
553	shall have affixed thereto the corporate seal of the district
554	which may be an impression thereon or facsimile thereof. No
555	warrant shall be drawn or issued against funds of the district
556	except for a purpose authorized by this act after the account or
557	expenditure for which the same is to be given in payment has
558	been ordered and approved by the board at a meeting in which a
559	quorum is present.
560	Section 28. A special account shall be set up which shall
561	require only the signature of the administrator of the hospital
562	or hospitals or such other employees as the board shall
563	determine for such purposes. The administrator’s account shall
564	be such sum or sums as the board deems necessary from time to
565	time and shall be used only as a payroll account or for such
566	other purposes as the board shall determine.
567	Section 29. The board is authorized and directed annually
568	to levy upon taxable real property only within the district, not
569	exempt by law, a sufficient tax necessary for the purposes and
570	needs of the district incurred in the exercise of the powers and
571	purposes herein granted. The rate of taxation per annum shall
572	not exceed two (2) mills on the dollar of the county assessed
573	valuation of the property within the district for tax purposes.
574	The term “mill” as used in this section shall be deemed to mean
575	one-tenth (1/10) part of one cent (1c) or one thousandth
576	(1/1000) of a dollar ($1).
577	Section 30. The levy by the board of the taxes authorized
578	by any provision of this act shall be by resolution of the board
579	duly entered upon the minutes of the board. Certified copies of
580	such resolution executed in the name of the board by its chair,
581	under its corporate seal, shall be made and delivered to the
582	board of county commissioners of Monroe County and to the
583	comptroller of the state no later than July 1 of each year. It
584	shall be the mandatory duty of the county commissioners of
585	Monroe County to order and require the county tax assessor of
586	the county to assess, and the county tax collector of the county
587	to collect the amount of taxes so assessed or levied by the
588	board of the district upon the taxable property in the district,
589	not exempt by law, at the rate of taxation adopted by the board
590	of the district for the year and included in the warrant of the
591	tax assessor and attached to the assessment roll of taxes for
592	said county of each year. The tax collector shall collect such
593	tax so levied by the board in the same manner as other taxes are
594	collected and shall pay the same over to the board within the
595	time and in the manner prescribed by law for the payment by the
596	tax collector of county taxes to the county depository. All
597	such taxes shall be held by the board and paid out by them as
598	provided in this act. The board is authorized to pay necessary
599	expenses to the forenamed officers for the assessment and
600	collection of taxes on a reasonable fee basis. If any surplus
601	shall occur in the operation and maintenance fund, the board is
602	authorized to use the surplus or any portion thereof to retire
603	bonded indebtedness, but not to the extent that the financial
604	security of the operation and maintenance fund shall be
605	impaired.
606	Section 31. The board is authorized to pay from the funds
607	of the district all expenses of the organization of the board
608	and all expenses necessarily incurred with the formation of the
609	district and all other reasonable and necessary expenses
610	approved and certified by the board, including the fees and
611	expenses of an attorney in the transaction of the business of
612	the district, and in carrying out and accomplishing the purposes
613	of this act. This section, however, shall not be construed to
614	limit or destroy any of the powers vested in the board by any
615	other section or provision of this act.
616	Section 32. (1) Subject to such provisions and
617	restrictions as may be set forth in the resolution authorizing
618	or securing any bonds issued under the provisions of this act,
619	the board shall have the power to enter into contracts with the
620	government of the United States or any agency or instrumentality
621	thereof, or with the state or any county, municipality,
622	district, authority, or political subdivision, private
623	corporation, partnership, association, or individual providing
624	for or relating to the construction or acquisition of additions,
625	extensions, and improvements to the hospital or hospitals,
626	medical facilities, or other health care related facilities, and
627	any other matters relevant thereto or otherwise necessary to
628	effect the purpose of this act, and to receive and accept from
629	any federal agency, state agency, or other public body grants or
630	loans for or in aid of said purposes and to receive and accept
631	aid or contributions or loans from any other source of either
632	money, property, labor, or other things of value, to be held,
633	used, and applied only for the purpose for which such grants,
634	contributions, or loans may be made.
635	(2) The board is hereby authorized and empowered to lease
636	or sell any real or personal property owned by the district, or
637	to otherwise relinquish and dispose of the district’s title or
638	right to immediate possession of such property, according to the
639	following terms and conditions:
640	(a) Any real or personal property of a fair value of less
641	than $2,500 may be leased or sold, or the title or right to
642	immediate possession otherwise relinquished or disposed of
643	according to the manner and procedure and according to the terms
644	and conditions the board at the time might determine.
645	(b) Any real or personal property of a fair market value
646	of more than $2,500 may be leased, or the right to immediate
647	possession otherwise relinquished, according to the procedures,
648	terms, and conditions that the board approves, to a public or
649	private health service organization for the provision of medical
650	services that the board cannot on its own provide, as authorized
651	by section 6.
652	(c) Any real or personal property of a fair value of more
653	than $2,500 may be sold, or leased for a term of more than 1
654	year and 1 day, or the title or right to immediate possession
655	otherwise relinquished or disposed of for a term of more than 1
656	year and 1 day, after the board has determined by appropriate
657	resolution that such property is surplus to the needs and
658	requirements of the district, and after the board has submitted
659	the property to the general public for offers by publishing a
660	Notice of Intent to Dispose of Property in a newspaper of
661	general circulation published in Key West at least 30 days in
662	advance of such lease, sale, or other disposition. Any person
663	desiring such property shall submit his or her offer to lease or
664	buy to the board during such 30-day period, or during such
665	longer period as the board might establish, along with the terms
666	and conditions of such offer. The published notice shall be
667	sufficient if it shall reasonably identify the property in
668	question and inform any persons interested in such property that
669	the board desires to dispose of said property and seeks offers
670	to lease or buy thereon. It is not required that such notice
671	specify the terms and conditions desired by the district, and if
672	such terms and conditions are included in such notice, or
673	otherwise provided, they are to be for general information only
674	and shall not prevent the board from accepting different terms
675	and conditions which the board might determine to be more
676	beneficial to the district. Offers submitted by the bidders are
677	not required to be sealed or to be kept confidential to the
678	district, unless otherwise specified in the published notice,
679	and any bidder may submit any number of alternate offers at any
680	time during the bidding period.
681	(d) The board is hereby authorized and empowered to accept
682	any bid upon surplus property, and to lease, sell, or otherwise
683	convey said property, in accordance with the provisions of this
684	section, or to reject all the bids, as the board might determine
685	to be in the best interests of the district.
686	(e) The board is authorized and empowered to convey to
687	Monroe County, or to any municipality or to any other
688	governmental body or agency of the State of Florida or of the
689	United States located partially or entirely within the
690	boundaries of the district, any surplus property for a nominal
691	consideration and according to those terms and conditions as the
692	board may at that time determine, regardless of the value of
693	such property, whenever it shall appear to the board that such
694	conveyance would be in the best interests of the district and
695	the residents thereof; provided, however, that such conveyance
696	for nominal consideration shall not be made until at least 30
697	days after the terms and conditions thereof shall have been
698	published in a newspaper of general circulation published in Key
699	West, or until residents and taxpayers of the district shall
700	have been afforded an opportunity to be heard upon such
701	conveyance at a regular meeting of the board.
702	(f) Except as authorized in this section, any real or
703	personal property of a fair market value of more than $2,500 may
704	not be leased, nor may right to immediate possession be
705	otherwise relinquished, for a term exceeding 1 year and 1 day.
706	Section 33. At least once each year the board shall
707	publish once in some newspaper published in the district, a
708	complete detailed annual statement of all moneys received and
709	disbursed by them since the creation of the district as to the
710	first published statement and since the last published statement
711	as to any other year. The statements shall also show the
712	several sources from which the funds were received and shall
713	show the balance on hand at the time of the published statement.
714	It shall show a complete statement of the financial condition of
715	the district.
716	Section 34. Each hospital, medical facility, or other
717	health care related facility established under this act shall be
718	for the use and benefit of the residents of the district.
719	Residents shall be admitted to the hospital or hospitals or any
720	of the related facilities and shall be entitled to
721	hospitalization and treatment, subject, however, to the rules
722	and regulations prescribed by the board effective as of the date
723	of admission of such resident. The board shall be authorized to
724	accept money from any welfare funds provided for Monroe County
725	or moneys available to the indigent patients from a federal,
726	state, or county agency or municipality or moneys available to
727	Monroe County from said governmental agencies for welfare and
728	hospital purposes, for the payment of costs of treatment and
729	care of indigent residents of the district; the board may
730	collect from patients financially able such charges as the board
731	may from time to time establish. The board may exclude from
732	treatment and care any person having a communicable or
733	contagious disease where such disease may be a detriment to the
734	best interests of the hospital or hospitals or related
735	facilities or which may constitute a source of contagion or
736	infection to the patients in its care, unless the institution
737	involved has a separate building or ward for the special
738	treatment of such persons and can properly and with safety to
739	the other patients retain the communicable or contagious case in
740	such separate ward or building. The board may extend the
741	privileges and use of a hospital or related facilities to
742	nonresidents of the district but who pay the rates established
743	by the board and upon such terms and conditions as the board may
744	from time to time by its rules and regulations provide.
745	However, the residents of the district wherein a hospital or
746	related facility is located shall have first claim to admission.
747	The board further shall have the power to furnish and extend the
748	benefits of a hospital or related facility and treatment to the
749	homes of indigent residents of the district. Each municipal
750	corporation situated within the district and the law enforcing
751	agencies of Monroe County shall be liable to the board for the
752	occupancy, care, medicine, and treatment of prisoners in the
753	custody of the municipal corporation or county officers who are
754	admitted to the hospital or other facility operated by the
755	board.
756	Section 35. Realizing that factors other than professional
757	must enter into qualification of those who practice medicine and
758	surgery, the board is authorized to promulgate and adopt rules,
759	regulations, and bylaws for the governing of the operation of
760	any hospital, nursing home, ambulance service, or such other
761	services as may be established under this act and the hospital
762	staff, nursing home, nursing home staff, ambulance service, and
763	medical staff; and the board is authorized to give, refuse,
764	grant, revoke, suspend, and otherwise curtail licenses and/or
765	privileges of staff members so that the welfare and health of
766	patients and the interests of any such hospital, nursing home,
767	and ambulance service may be best served at all times. The
768	board further is authorized to set up rules and regulations for
769	the hospital, nursing home, and an ambulance service, which
770	terms shall include nurses on general duty or on private duty
771	attending patients, and all other personnel in the hospital,
772	nursing home, and ambulance service who are in any capacity in
773	attendance upon patients. There shall be no liability on the
774	part of, and no cause of action of any nature shall arise
775	against any hospital, nursing home, hospital medical staff,
776	ambulance service, district board of commissioners, individually
777	or collectively, or hospital disciplinary body or its agents or
778	employees for any action taken in good faith and without malice
779	in carrying out the provisions of this section. However,
780	nothing in this section shall be construed to relieve any person
781	of liability in the case of medical malpractice or negligence.
782	Section 36. The board on behalf of the district shall
783	secure and keep in force in amounts it may determine reasonable,
784	in companies duly authorized to do business in Florida,
785	liability insurance covering vehicles and premises. The board
786	on behalf of the district shall attempt to secure and keep in
787	force in amounts it may determine reasonable, in companies duly
788	authorized to do business in Florida, liability insurance
789	covering professional malpractice. In the event such
790	professional malpractice insurance is not available or is
791	otherwise available at costs the board deems unreasonable, the
792	board on behalf of the district may elect to self-insure for
793	such risk. In consideration of the premium at which each policy
794	of insurance, if any, shall be written, it shall be part of the
795	insurance contract that the insurance company shall not be
796	entitled to the benefit of the defense of governmental immunity
797	for the insured by reason of exercising a governmental function
798	on any suit brought against the insured. Immunity of the
799	hospital district against liability damages is waived to the
800	extent of liability insurance carried. However, no attempt
801	shall be made at the trial of any action against the district to
802	suggest the existence of any insurance which covers in whole or
803	in part any judgment which may be rendered in favor of a
804	plaintiff. The board, on its behalf individually and on behalf
805	of the district, shall be indemnified by the district for any
806	and all acts taken by it, both collectively and individually, in
807	good faith and without malice in carrying out their duties under
808	this act.
809	Section 37. The board is empowered to destroy any of its
810	records together with any of the records of the hospital or
811	hospitals or related facilities established under this act
812	provided that the records are photographed or microfilmed prior
813	to their destruction.
814	Section 38. It is declared to be the legislative intent
815	that if any section, subsection, paragraph, sentence, clause, or
816	provision of this act is held invalid, the remainder of the act
817	shall not be affected.
818	Section 39. This act shall become effective only upon
819	approval by a majority vote of the qualified freeholder electors
820	voting in a referendum election in which a majority of the
821	freeholders who are qualified registered electors in the
822	district shall participate, to be held in Monroe County at a
823	special election to be called by the county commission within
824	forty-five (45) days from the date this act is filed with the
825	Secretary of State. If the election so held is favorable to the
826	establishment of a hospital district, then the cost of said
827	election shall be borne by the hospital commission created
828	thereby. If such measure fails, then the cost of the special
829	election shall be borne by the county commission of Monroe
830	County.
831	Section 4. If any provision of this act or the application
832	thereof to any person or circumstance is held invalid, the
833	invalidity shall not affect other provisions or applications of
834	the act which can be given effect without the invalid provision
835	or application, and to this end the provisions of this act are
836	declared severable.
837	Section 5. This act shall be construed as a remedial act
838	and shall be liberally construed to promote the purpose for
839	which it is intended.
840	Section 6. Chapters 67-1724, 69-1322, 72-617, 73-555, 73-
841	558, 75-450, 77-600, 77-601, 77-602, 77-603, 78-565, 79-511, 82-
842	414, 87-459, 89-551, and 94-415, Laws of Florida, are repealed.
843	Section 7. This act shall take effect upon becoming a law.
844